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与动静脉内瘘早期血栓形成相关的免疫细胞异质性群体

Heterogeneous Population of Immune cells Associated with Early Thrombosis in Arteriovenous Fistula.

作者信息

Samra Gunimat, Rai Vikrant, Agrawal Devendra K

机构信息

Department of Translational Research, Western University of Health Sciences, Pomona CA 91766, USA.

出版信息

J Surg Res (Houst). 2022;5(3):423-434. doi: 10.26502/jsr.10020237. Epub 2022 Jul 7.

Abstract

End-Stage Renal Disease (ESRD) is a growing cause of morbidity and mortality in the practice of modern medicine. Advances in medicine have elongated the average life span and subsequently made chronic diseases prevalent. Hemodialysis is the main treatment that is used to treat ESRD and is a clinical procedure that is being re-imagined with novel approaches to improve patient and clinic practicality and effectiveness. Arteriovenous Fistulas (AVF) are now used in place of catheters due to their higher success and lower co-morbidities. The main drawback of AVF is the time gap that is needed from the surgical creation of AVF to its use. During this time, the AVF is susceptible to thrombosis and occlusion rendering the fistula ineffective for treatment. Immune cells play a major role in vascular pathologies and macrophages, dendritic cells, and T-regulatory cells are the main cells seen during the inflammatory and anti-inflammatory phases. However, the role of immune response and immune cells in AVF maturation is poorly understood. This study aimed to investigate the immune response and immune cell expression in femoral vessels after AVF creation in a miniswine model of AVF using immunohistochemistry and qRT-PCR. The results of this study revealed an increased expression of immune cells in AVF vessels and suggest an association of immune response with AVF creation and maturation.

摘要

终末期肾病(ESRD)在现代医学实践中已成为发病率和死亡率不断上升的一个原因。医学的进步延长了平均寿命,进而使慢性病普遍化。血液透析是治疗ESRD的主要方法,并且作为一种临床程序,正通过新颖的方法进行重新构想,以提高患者和临床的实用性及有效性。由于动静脉内瘘(AVF)成功率更高且并发症更低,现在已被用于取代导管。AVF的主要缺点是从外科手术创建AVF到其投入使用所需的时间间隔。在此期间,AVF易发生血栓形成和闭塞,导致内瘘无法有效用于治疗。免疫细胞在血管病变中起主要作用,巨噬细胞、树突状细胞和调节性T细胞是炎症期和抗炎期的主要细胞。然而,免疫反应和免疫细胞在AVF成熟过程中的作用却鲜为人知。本研究旨在使用免疫组织化学和qRT-PCR,在AVF小型猪模型中研究AVF创建后股血管中的免疫反应和免疫细胞表达。本研究结果显示,AVF血管中免疫细胞的表达增加,并提示免疫反应与AVF创建和成熟之间存在关联。

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